Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | D53808 | MD |
NPI | 1033184734 |
---|---|
Provider Name | Dr. Stephanie Neukum |
First Address | Perry Hall, MD 21128-9144 |
Second Address | Columbia, MD 21044-2983 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H12950 | (02) | MD |